| NPI | 1386898237 |
|---|---|
| Former Name | ANGELA M. EASTBURN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111465) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA1177) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2022-01-13 |